Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs-negative idiopathic peptic ulcers show refractoriness and high recurrence incidence: Multicenter follow-up study of peptic ulcers in Japan

Takeshi Kanno, Katsunori Iijima, Yasuhiko Abe, Makoto Yagi, Sho Asonuma, Motoki Ohyauchi, Hirotaka Ito, Tomoyuki Koike, Tooru Shimosegawa

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background and Aim: Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs (NSAIDs)-negative idiopathic peptic ulcers (IPU) have attracted attention in Japan and other developed countries. The aim of the present study was to clarify the healing rate of IPU and the risk of recurrence. Methods: We conducted a retrospective follow-up study of patients with peptic ulcer disease (PUD) who were diagnosed in our previous multicenter-prospective study. Three hundred and eighty-two patients from four institutions in the Tohoku district were enrolled. Enrolled subjects were divided into four groups according to H. pylori infection and intake of NSAIDs. In these patients, we checked treatment course, healing rate during 3 months, and recurrence rate. Results: Healing rates in the: (i) simple H. pylori group; (ii) H. pylori (+)/ NSAIDs (+) group, (iii) simple NSAIDs group; and (iv) IPU group, were 95.0%, 94.9%, 73.3%, and 77.4%, respectively. The healing rate of the IPU group was significantly lower than that of both the simple H. pylori group and the H. pylori (+)/ NSAIDs (+) group (P < 0.01). The recurrence rate of 13.9% in the IPU group was much higher than the 2.1% in the simple H. pylori group (P < 0.01). Additionally, the cumulative recurrence rates by the Kaplan–Meier method in the IPU group were significantly higher than those of the simple H. pylori group (P = 0.015). Conclusion: We demonstrated that the clinical course of peptic ulcers is considerably different depending on the cause. IPU could be refractory to treatment and prone to recur compared with simple H. pylori ulcers.

Original languageEnglish
Pages (from-to)556-563
Number of pages8
JournalDigestive Endoscopy
Volume28
Issue number5
DOIs
Publication statusPublished - 2016 Jul 1

Keywords

  • Helicobacter pylori-negative
  • Idiopathic peptic ulcer
  • Non-steroidalantiinflammatory drugs-negative
  • Recurrence
  • Refractory

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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